Employer

Pennsylvania Farm Bureau Welfare Wrap

214 Senate Avenue, Camp Hill, PA 17011 · EIN 23-1382876 · Jan 1, 2025 to Dec 31, 2025

Plan year 2025

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Schedule A

Direct compensation

Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.

Visible subtotal $87,463

Coverage	Carrier	Broker	Lives	Direct comp
Medical	Capital Advantage Assurance Company	Pfb Member Service Corp	24	$6,384 1.7% of $374,813
Dental	United Concordia Insurance Company	Pfb Member Service Corp	1970	$76,868 8.7% of $887,957
Vision	Metropolitan Life Insurance Company	Pfb Member Service Corp	1732	Comp not disclosed Premium $120,235
Life	United Of Omaha Life Insurance Company	Gallagher Fiduciary Advisors, LLC	74	$3,971 19.2% of $20,677
Cancer Care	Aflac	Matthew G Burnside	2	$91 4.0% of $2,292
Cancer Care	Aflac	Vicki J Veltri	2	$48 2.1% of $2,292
Cancer Care	Aflac	Bryan Fish	2	$21 0.9% of $2,292
Cancer Care	Aflac	James D Maxwell	2	$15 0.7% of $2,292
Cancer Care	Aflac	Justin Mudgett	2	$15 0.7% of $2,292
Cancer Care	Aflac	Khs Benefits LLC	2	$12 0.5% of $2,292
Cancer Care	Aflac	Ethan Robert Riffe	2	$9 0.4% of $2,292
Cancer Care	Aflac	Robert Wertz	2	$9 0.4% of $2,292
Cancer Care	Aflac	Kaylie A. Ling	2	$6 0.3% of $2,292
Cancer Care	Aflac	James C Maxwell	2	$4 0.2% of $2,292
Cancer Care	Aflac	David Morningstar	2	$3 0.1% of $2,292
Cancer Care	Aflac	Jeremy A Feldman	2	$2 0.1% of $2,292
Cancer Care	Aflac	Dominick J Lacaria	2	$2 0.1% of $2,292
Cancer Care	Aflac	Kelly Lynn Feldman	2	$1 0.0% of $2,292
Cancer Care	Aflac	Brian W Patten	2	$1 0.0% of $2,292
Cancer Care	Aflac	Joy Grube Padgelek	2	$1 0.0% of $2,292

Schedule C

Plan-paid amounts to each named party on the filing, with the role they reported. This is not a carrier commission and is not added to Schedule A.

No Schedule C parties in this year.

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